Comparison of force profiles from two musculoskeletal palpation methods: A methodological study

Area of Science:

• Biomedical Engineering
• Clinical Diagnostics
• Musculoskeletal Research

Background:

• The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocol outlines dynamic palpation guidelines for temporomandibular joint (TMJ) assessment.
• Current DC/TMD recommendations involve a 5-second, 1-kg force dynamic palpation of the lateral condylar pole.
• The accuracy and precision of forces applied during manual DC/TMD palpation are not well-established.

Purpose of the Study:

• To evaluate and compare the force profiles generated by manual dynamic palpation versus palpation using a device (palpometer).
• To assess these methods against the force and time parameters recommended by the DC/TMD protocol.
• To determine the accuracy and precision of each palpation technique.

Main Methods:

• Nineteen healthy adults performed dynamic palpation on a force sensor, applying 0.5, 1.0, and 2.0 kg forces within 2 and 5-second target times.
• Palpation was conducted manually using the index finger and with a calibrated palpometer.
• Accuracy (relative force difference) and precision (coefficient of variation) were analyzed using repeated measures ANOVA over ten repetitions.

Main Results:

• The palpometer demonstrated significantly higher accuracy (lower error) and precision (lower CV) compared to manual palpation (p < .001).
• Significant differences in accuracy and precision were observed across varying forces, but not palpation durations.
• Participants frequently exceeded target palpation times, tending to apply forces more quickly regardless of the method (p > .063).

Conclusions:

• Device-assisted palpation with a palpometer provides superior accuracy and precision for dynamic force assessment in TMJ evaluations.
• Despite improved force measurement, achieving consistent and standardized palpation duration remains a limitation for both manual and device-assisted methods.